First Aid - GUIDE & TIPS

[sakuraguy]

First Aid - GUIDE & TIPS

This First aid section is an essential guide to providing immediate help required by someone who is ill or injured, before medical help is available. By practicing the step-by-step techniques described in this first aid section according to situation, you can learn how to give first aid quickly, calmly and effectively. Clear instructions help you deal with common first aid situation, while practical life saving techniques are explained in full. You will learn how to deal with other potentially life threatening situations or injuries, and how to keep a patient alive until medical treatment is available. Even where a situation is not immediately life threatening, applying first aid techniques is valuable in helping a patient to recover more quickly.

A well-stocked first-aid kit, kept within easy reach, is a necessity in every home. Having supplies gathered ahead of time will help you handle an emergency at a moment's notice. You should keep one first-aid kit in your home and one in each car. Also be sure to bring a first-aid kit on family vacations.


Things you should have in our first aid box:

Sterile gauze
Adhesive tape
Adhesive bandages in several sizes
Two pairs of Latex, or other sterile gloves (if you are allergic to Latex).
Eye wash solution to flush the eyes or as general decontaminant.
Tweezers
Sharp scissors
Safety pins
Disposable instant cold packs
Tube of petroleum jelly or other lubricant
Thermometer
Aloe vera gel
Aspirin or nonaspirin pain reliever
Soap
Antiseptic solution
Flashlight



SakuraGuy
Zerotohundred.Com

 

[sakuraguy]

This thread will cover:

Alcohol Poisoning
Anaphylactic Shock
Asthma
Back and Spinal Injury
Bleeding from the Head or Palm
Bleeding From Special Sites
Bleeding
Breathing Difficulties
Burns and Scalds
Chemical Burns and Eye Burns
Chest or Abdominal Wounds
Concussion
Controlling Bleeding from the Mouth and Nose
Crush Injuries
Diabetes
Drowning
Drug Poisoning
Emergency Childbirth
Epilepsy
Extreme Cold
Extreme Heat
External Bleeding
Eye Wounds
Food Poisoning
Fractures of the Arm and Hand
Fractures, Dislocations and Soft Tissue Injuries
Fractures of the Ribcage
Fractures of the Skull Face and Jaw
Fractures of the Upper Body
Heart Problems
Injuries to the Lower Body
Injuries to the Lower Leg
Internal Bleeding
Miscarriage
Poisoning from Household Chemicals
Poisoning from Industrial Chemicals
Poisoning
Shock
Sprains and Strains
Stroke
Other Types of Burn
Unconscious Casualty
Unconsciousness
If You Have to Move the Casualty

 

[sakuraguy]

Alcohol Poisoning

Alcohol depresses the central nervous system, which is the centre of our thoughts, feelings and senses, and responsible for coordinating all movement and body processes. In the early stages of drinking, this creates a relaxed feeling and impression of increased confidence. Continued drinking can affect the ability to make rational decisions and, as consumption increases, slow down breathing and even cause loss of consciousness. The effect of alcohol on the body is affected by factors including weight, body fat and history of alcohol intake. What may be a safe level for one person may have serious effects for another.

Effects of high intake

There are four key risks following a high alcohol intake:

Injury, following poor decision-making and clumsiness.
Vomiting, leading to choking in an unconscious person.
Hypothermia - alcohol dilates the blood vessels, making exposure to the cold a greater risk.
Slower breathing and, ultimately, breathing stopping.
Signs and symptoms
What has happened. Consider this carefully - a person who has suffered a head injury or stroke may show similar signs and symptoms to somebody who is drunk
Strong smell of alcohol
Lapsing in and our of consciousness. Rousable at first but eventually slipping into full unconsciousness
Red, sweating face
Deep, noisy breathing - sounds of snoring
Strong, fast pulse
Eventually, breathing may become shallower and the pulse weaker and faster.

Treatment
Monitor and maintain the person's airway and breathing. Be prepared to resuscitate the person if necessary.
If the person becomes unconscious, place into the recovery position. The person is extremely likely to be sick, so watch carefully for signs of vomit and remove from the mouth as needed.
If the person is conscious, help into a comfortable position and encourage him or her to keep still.
Check for additional injury and give treatment as appropriate.
Protect from extremes of cold to reduce the risk of hypothermia developing. If the
person is unconscious, you suspect further injury, you are worried that other substances may have been consumed or you have any other doubts as to their condition, call an ambulance. Do not underestimate the risk of alcohol poisoning.
If you do not feel that an ambulance is necessary, ensure that the person is not left alone, that the airway and breathing are regularly checked and that the casualty is in a safe, warm place until he is better.

Long-term effects of alcohol

Drinking alcohol within safe limits may be beneficial for health, helping to protect against stroke and heart disease, but if you have more than a couple of alcoholic drinks a day, there are more risks than benefits.

Weight gain: alcohol contains many calories and regular drinkers often put on weight.
Reduced intellectual function: brain cells that control memory and learning are damaged by alcohol. Alcohol is also damaging to mental health causing increased anxiety and depression.
Increased risk of developing many types of cancer (this risk is even higher if you smoke as well).
Increased risk of circulatory disorders such as high blood pressure and stroke.
Reduced fertility in both men and women and damage to the foetus if you drink heavily during pregnancy.
Damage to the liver and other organs; digestive problems such as ulcers.

 

[sakuraguy]

Anaphylactic Shock

An allergy is hypersensitivity to a substance (allergen) that is not normally considered to be harmful. Allergies are triggered by the immune system, which reacts to the allergen as though it were a harmful substance invading the body. The most extreme response is anaphylaxis, which may result in anaphylactic shock which, if untreated, can kill.

Causes of anaphylaxis
This extreme allergic reaction has an intense effect on the body, causing a sudden drop in blood pressure and narrowing of the airways that can be fatal. Anaphylactic shock can be caused by anything, but among the most common triggers are: nuts (for those who are particularly sensitive, even touching the trace of a nut can be potentially fatal), seafood, insect stings and bites, and drugs (some people have a very extreme reaction to penicillin, for example).

As with asthma, the number of people suffering allergic reactions appears to be increasing. Whether this is because people are becoming more sensitive to allergens (the substances that cause allergic reactions) or whether we are just becoming better at detecting allergies, nobody is really sure.

Signs and symptoms
One of the main effects of severe anaphylaxis is a constriction of the air passages in a similar way to asthma but generally more severe, preventing the intake of any oxygen at all. There may be a history of contact with a particular allergen, the thing that triggers the attack. Anaphylaxis can happen very quickly, within seconds.

Signs and symptoms includes:

Difficulty breathing
Pale skin and blue lips
Blotches on the skin
Rapid pulse
Breathing and heartbeat stopping
Treatment
Call an ambulance immediately. The casualty needs adrenaline to counteract the reaction.
If the casualty is a known sufferer she may have an adrenaline injection. Help her to administer this. If you have been trained and the casualty is unable to do so, you may give the injection.
Place the casualty in the most comfortable position and reassure her.
If the casualty becomes unconscious, place in the recovery position.
Monitor the casualty's breathing and circulation and be prepared to resuscitate if necessary.

Skin prick test for allergies

Skin prick tests are simple procedures carried out to find out what substances (allergens) cause allergic reactions in an affected person. Extracts of allergens that commonly cause allergic reactions, such as food, pollen and dust are made into dilute solutions and are then placed on the skin. The skin is pierced to allow the substance to be absorbed.

Dilute solutions of substances that a person is thought to be allergic to are placed on the skin, usually the arm, and the skin is then pricked with a needle. Several different allergens can be tested on the skin at the same time.
An allergic reaction usually takes place within 30 minutes of the test. lf the person is allergic to the substance a red weal, indicating a positive reaction, appears at the site where the needle pricked the skin.
Handling an attack

Many anaphylaxis sufferers carry an auto-injector with a measured dose of a known treatment for an attack, most commonly adrenaline. This will often look like a pen. It is easily administered by placing against the skin and clicking the end. Help the person having the attack, to find and inject the medication.

 

[sakuraguy]

Asthma

Asthma attacks cause the muscles of the air passages to go into spasm, making it very difficult for the sufferer to breathe, particularly to exhale. Attacks may be triggered by an allergy or by stress, for example being involved in an accident. Sometimes the cause of the attacks for a particular sufferer is never identified. There is evidence to suggest that asthma appears to be increasing in frequency, or at least in diagnosis.

Signs and symptoms
History of the condition (although some people may not realise that they are asthmatic and the first attack may be a very severe one)
Difficulty in breathing, particularly breathing out
Wheezing or otherwise noisy breathing
Inability to speak
Pale skin and potential blueness, particularly around the lips, caused by lack of oxygen
Distress, dizziness and confusion as it becomes harder to get oxygen into the body
Unconsciousness and then breathing stopping
Treatment
An asthma attack should not be underestimated. While the preventive treatments are very effective, and the drugs to relieve attacks usually work very well, left untreated, a serious attack can be fatal. The strain of a serious asthma attack can cause the breathing to stop or the heart to cease beating. You should be prepared to resuscitate if necessary.

Reassure the casualty as this will have a positive effect on his breathing.
Help the casualty into a sitting position, leaning slightly forwards, as most people with asthma find this an easier position for breathing.
If the casualty has medication, enable him to use it. Inhalers are the main form of treatment and are generally blue.
If this is the first attack, the medication does not work within 5 minutes or the casualty is in severe distress, then call an ambulance. Help the casualty to take medication every 5 to 10 minutes.

If the attack eases and the casualty finds it easier to breathe, he will not need immediate medical attention but should advise a doctor of the attack. A person will often be very tired following an attack so it is best to ensure that he is accompanied home to rest.

Using an inhaler
Known asthmatics are usually prescribed an inhaler, a device that administers a measured dose of drugs inhaled directly into the lungs, where it will have a near-instant effect. Inhalers for prevention are generally brown and inhalers for the relief of attacks are usually blue.

Young children may find it hard to use an ordinary aerosol inhaler and will need a spacer instead. Medication is put into the end of the spacer and the child breathes normally to take this in.

Children under the age of four will usually require a face mask to use with the spacer as they cannot coordinate their breathing to inhale the drugs.

If a member of your family is an asthmatic, make sure that everyone understands the importance of knowing where the inhaler is and that there is always enough medication in the house.


Asthma
Asthma is a very common disorder with an estimated four to five percent of the population being affected. It is perhaps the only common treatable condition that is increasing in terms of prevalence, severity and mortality, especially in children.

Asthma is a chronic inflammatory condition of the airways. In susceptible individuals this inflammation causes recurrent episodes of coughing, wheezing, chest tightness, and difficult breathing. Inflammation makes the airways sensitive to stimuli such as, chemical irritant, tobacco smoke, cold air, or exercise. When exposed to these stimuli, the airways may become swollen, constricted, filled with mucus, and hypersensitive to stimuli.

The inflammation causes associated increase in existing airway hyper responsiveness to variety of cold air and virus. Exposure of patients to these stimuli provokes a variety of changes in airways including broncho constriction, airway oedema, chronic mucus plug formation and airway remodelling. The recurrent episodes of wheezing, breathlessness, chest tightness and coughing experienced by patient with asthma, particularly at night and in early morning, is usually associated with airflow obstruction.

Asthma attacks all age groups but often starts in childhood. It is a disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person. In an individual, they may occur from hour to hour and day.

This condition is due to inflammation of the air passages in the lungs and affects the sensitivity of the nerve endings in the airways so they become easily irritated. In an attack, the lining of the passages swell causing the airways to narrow and reducing the flow of air in and out of the lungs.

Asthma, technically called bronchial asthma, is a disease of the bronchial tubes that lead from the windpipe, or trachea, into the lungs. The bronchial tubes ordinarily do not furnish any marked resistance to the entrance or exit of air. However, in asthmatic attacks, the bronchial tubes tend to close down, causing asthmatic wheezing. In severe attack, the sufferer seems almost to be suffocating. He apparently uses all his strength just trying to breathe. He becomes pale and bluish and often perspires. Fortunately, most attacks are mild and do not last long. Many of them can be prevented or stopped by medical treatment.

Bronchial asthma is a chronic illness marked by these attacks. In severe cases, the bronchial tubes become swollen and ofter greater resistance to treatment. Plugs of clinging mucus may form in the tubes and cause chronic irritation and coughing. They are dislodged and brought up as sputum. If the attacks are frequent, prolonged, and severe, the lung tissue is damaged. This puts a strain on the heart. The average case of asthma is mild and more of a recurrent nuisance than a threat to health. It is always essential to get and follow competent medical advice, especially in the cases of young persons, before asthma can damage the heart or lungs.

The resulting airflow limitation is reversible, either spontaneously or with treatment; when asthma therapy is adequate, inflammation can be reduced over the long term, symptoms can usually be controlled, and most asthma related problems prevented.

 

[sakuraguy]

Recognising Back and Spinal Injury

The spine is made up of a number of small bones called vertebrae. These form the backbone or spinal column, through which run the spinal cord, the part of the central nervous system connecting all parts of the body with the brain, and major blood vessels. Injuries to the back are caused in a number of ways: through direct impact (such as a heavy blow to the neck or back); indirect impact (landing on the head or feet without bending the legs, thus allowing the force to travel up the body); and when the head is violently thrown forwards and backwards (common in car accidents).

Complications with back injury
The biggest danger with back injuries is the risk of nerve damage. The spinal cord containing the spinal nerves runs down the centre of the vertebrae and fractures can sever or pinch these nerves, leading to partial or full paralysis. If the fracture is high in the neck, breathing may stop. Displaced vertebrae or swelling due to blood loss can also apply pressure to the spinal cord, leading to nerve damage.

Not all broken backs result in immediate damage to the spinal cord. However, the risk of spinal cord injuries is greatly increased if bones are broken, and any suspected fracture of the spine should be treated with extreme care.

Suspect a broken back or potential nerve damage if the accident involved:

Rapid slowing down of movement.
A fall from a height.
A sharp blow directly to the back.
Injury to the face or skull (as this often results from the head being thrown backwards and forwards).
Signs and symptoms of a broken back
Dent or step in the spine, which may indicate a displaced vertebra
Bruising or swelling over the backbone
Complaint of pain in the back
Tenderness over the area of the break
First Aid Treatment
Any spinal injury is potentially serious and you should seek emergency assistance immediately. The treatment for injuries to the back is to keep the injured person still while monitoring and maintaining airway and breathing. The general rule for dealing with broken bones or spinal cord damage is to keep the casualty in the position that you found him until a doctor arrives, taking particular care to ensure the head is immobilised

Unless the person is in danger or becomes unconscious and requires resuscitation, do not move him from the position in which he was found. If you have been trained to do so, you can move the head into the neutral position before immobilisation. Remain in this position until emergency help arrives.

If the casualty is conscious and already lying down, leave him where he is. If the casualty is still walking around, support him in lying down on the ground. If you can, put a blanket or coat underneath before you lie the person down.
Ensure that an ambulance has been called at the earliest opportunity.
Tell the person to keep still until medical help arrives and reassure him.
Hold the casualty's head still by placing your hands over the ears and your fingers along the jawline.
Do not remove your support from the head until help arrives.
If the casualty is unconscious, maintaining a clear airway is your first priority.

Back pain

There are many causes of back pain. Among the most serious is damage to the spinal cord, which may lead to paralysis or meningitis. More commonly, neck or lower back pain can be caused by muscle strain or damage to the ligaments or the discs between the vertebrae (the back bones). Broken ribs or damage to the muscles between the ribs at the back may also cause back pain.

Signs and symptoms
Dull or severe pain, usually made worse by movement
Tension in the neck or shoulders
Pain travelling down limbs
First Aid Treatment
Check the nature of the incident carefully ­ if the pain is related to a recent heavy fall or other accident, assume that there may be spinal cord damage and treat as for a broken back.
Help the casualty to lie down. Usually the most comfortable position will be flat on the back on a hard surface.
If the symptoms do not ease, advise the casualty to see a doctor.
If back pain is accompanied by signs of spinal cord damage, such as numbness, pins and needles, or by headaches, nausea, vomiting, fever, or a deterioration in the level of consciousness (e.g. increasing drowsiness), call an ambulance.

The spine

The spine or backbone enables the body to stand upright, supports the head and protects the spinal cord. Joints between vertebrae give the spine flexibility; ligaments and tendons stabilise the spine and control movement.
Signs and symptoms of spinal cord damage
Loss of movement below the site of the break
Pins and needles in the fingers or toes or throughout the body
Feeling strange, perhaps 'jelly-like'
Numbness
If any of these signs and symptoms is present, or if the nature of the accident indicates a potential fracture, assume that a bone is broken and keep the person still until help arrives.

Warning
Do not give anything to eat or drink - the casualty may need a general anaesthetic in hospital.
Do not move the casualty unless he is in danger or needs resuscitation.

 

[sakuraguy]

Bleeding from the Head or Palm

Bleeding from the head is usually caused by a blow. The scalp in particular has a rich blood supply and even a small wound can bleed heavily. The palm of the hand is commonly cut while cutting objects or through a fall. Bleeding is often severe as the palm also has a rich blood supply. There are many tendons and nerves in the hand, and wounds to the palm may be accompanied by loss of movement or feeling in the fingers.
Signs and symptoms of skull fracture, concussion and compression
Skull fracture

Bruising to the eye socket
Pain
A bump or dent in the skull
Straw-coloured fluid coming from one or both ears
Casualty becomes increasingly drowsy and unresponsive over a period of time. Does she respond slowly to questions or commands? Is she having problems focusing?
Concussion

Pale skin
Dizziness, blurred vision or nausea
Headache
Brief or partial loss of consciousness
Compression

Person becomes increasingly drowsy and unresponsive
Flushed and dry skin
Slurred speech and confusion
Partial or total loss of movement, often down one side of the body
One pupil appears to be larger than the other
Noisy breathing, which becomes slow
Slow, strong pulse
How to treat head bleeds

Treatment should include taking full details of what happened and checking for signs of head injury, such as skull fracture, concussion or compression.

Help the injured person to sit or lie down.
Check for any signs of head injury. Treat as appropriate.
Using a sterile bandage, apply direct pressure to the wound to stop the bleeding.
Cover the wound with a sterile dressing or a clean pad. Tie this in place with a bandage.
Take or send the casualty to hospital as soon as possible.
If the casualty becomes unconscious, monitor and maintain airway and breathing and be prepared to resuscitate as necessary.

How to treat bleeding from the palm

Help the casualty to sit or lie down. Apply direct pressure to the wound and raise the arm. lf the person has had a fall, take care to rule out a broken arm or collar bone before raising the arm.
Place a sterile dressing or clean pad in the hand and ask the casualty to grip her fingers over it. Bandage the fingers so that they are clenched over the pad. Leave the thumb exposed. lf there is an embedded object in the wound, treat the hand flat and bandage around the object. lf tendon damage means that the fingers cannot be clenched, bandage the wound with the hand flat.
Treat for shock if necessary. Keep the casualty warm, at rest and reassure him or her.
Support the arm in an elevation sling and take or send the casualty to hospital.

 

[sakuraguy]

Bleeding From Special Sites

Bleeding from bodily orifices includes nosebleeds, bleeding from the ear, mouth, vagina, anus and urethra. It may be an indication of a serious disorder.
Nosebleed
Nosebleeds are very common and often the cause is unknown. For general treatment of uncomplicated nosebleed, and Controlling Bleeding from the Mouth and Nose. If the bleed follows a heavy impact to the nose, then assume that there may be a broken nose or cheekbone.
How to treat nosebleeds in adults
Lean forward and spit blood into a handkerchief or some other receptacle.
Pinch the nose just below the hard bit at its top and apply firm pressure for 10 minutes (this is the amount of time it takes for a clot to form). If the bleeding has not stopped after 10 minutes, apply pressure for two further periods of 10 minutes. If it is still bleeding then either take or send the casualty to hospital.
Once the bleeding has stopped, advise the casualty not to scratch, pick or blow his nose, not to drink hot liquid and not to exert himself, as all these activities can dislodge the clot and cause the bleedlrlg to start again.
Bleeding from the ear
If the blood from the ear is thin and watery then it is likely that there has been some damage to the skull, and possibly the brain, as the blood is mixing with the fluid that cushions the brain. This is a very serious injury and the emergency services should be called as soon as possible. Keep the casualty as still as you can and gently rest the head, injured ear down, with a clean pad held over the ear for the blood to drain into. Do not tie this pad in place. Keep a check on the casualty's airway and breathing and be prepared to resuscitate if necessary.

If the blood is bright red and is accompanied by earache, deafness, a sudden change in pressure or an explosion then it is likely to be a burst eardrum. Again, keep the injured ear downwards, hold a clean pad in place and seek medical attention.

Bleeding from the mouth
If bleeding from the mouth follows a direct impact to the face it is likely that the bleed has been caused by damage to the teeth, gums or tongue. There may also be damage to the jaw and cheekbones.

Bright red and frothy bleeding from the mouth may be a sign of damage to the lungs.

Dark red blood being coughed up from the mouth may be a sign of a burst stomach ulcer. Seek urgent medical attention.

Bleeding from the vagina
The most likely reason for vaginal bleeding is menstruation (periods). lf this is the case and the bleed is accompanied by cramps then a woman may wish to take her normal painkillers.

A woman complaining of vaginal bleeding not related to her periods should be given privacy and sensitive handling, with gentle questioning to determine the cause. For all vaginal bleeding, provide sanitary pads or a clean towel where possible. Where the bleeding is potentially pregnancy-related, do not dispose of old pads of any blood loss.

Instead, move these discreetly away from the woman to be checked by medical staff.

Bleeding in early pregnancy may be an indication of a miscarriage, but there are a number of other potential causes. Make the woman comfortable and seek advice from her midwife or doctor. If the bleeding is severe and/or she is displaying signs of shock, call an ambulance.

In later pregnancy a bright red, painless bleed may indicate a serious problem with the placenta. Make the woman comfortable, call an ambulance and treat for shock.

If the bleeding is as a result of an accident or recent assault, call an ambulance and treat for shock.

Bleeding from the anus
Bleeding from the anus may be bright red and fresh looking. If it follows a recent accident, this may indicate injury to the anus or lower bowel. Treat for shock as appropriate and seek medical help.

Black, tarry blood has been partially digested and indicates a potential injury to the upper bowel. Again, treat for shock as appropriate and seek medical help.

Bleeding from the urethra
Blood In the urine, particularly following an accident, may indicate injury to the bladder, kidneys or other internal organs. It may also accompany a broken pelvis where the bone has damaged the bladder. Treat for shock as appropriate and seek medical help as quickly as possible. There is no way of detemining the seriousness of the situation until it is in expert hands.

 

[sakuraguy]

Bleeding

Blood is carried around the body in a transport system of arteries, capillaries and veins, and any damage to this network results in bleeding. Bleeding can be both external and internal. External bleeding involves a break to the skin surface, known as a wound, which can take many different forms. Internal bleeding is bleeding that occurs inside the body when there is no external injury for the blood to escape from. The most common form of internal bleeding is a small bruise from a minor impact. Heavy impact from car accidents, fights or falls, for example, can lead to serious internal bleeding, which may kill.

Transport of blood

Arteries have thick muscular walls, which contract. This pushes blood out from the heart under pressure. The blood contained within them is full of oxygen, which has been collected from the lungs, and the main function of the arteries is to take this oxygen-rich blood to the organs and body tissue. Because the blood is under pressure, and is so full of oxygen, arterial bleeding is characterised by bright red blood pumping from an injury. Arterial bleeding is very serious as blood is rapidly lost.

Veins have thin walls and return blood from the organs and tissues to the heart. They do not have muscles of their own and rely on the actions of the muscles around them to squeeze the blood around. To keep the blood moving in one direction around the body, they have a series of one-way valves that ensure a one-way flow. When these valves deteriorate, blood pools up in the veins making them swell up. This weakens the vein wall, resulting in a condition known as varicose veins. While the blood loss from a bleeding vein does not tend to be as quick as an arterial bleed, it does nonetheless have the potential to be a very serious and even fatal injury. Bleeding from a vein will seem to flow from an injury and as it has little or no oxygen it will appear to be a dark red.

Capillaries are very thin-walled vessels. Blood is forced through them under pressure, causing the food and oxygen stored in the blood to be pushed out into the body tissues and organs.

Types of injury
Small bleeds are very common and rarely need much treatment. Large blood loss may lead, if untreated, to shock and, potentially, death.

IncisionsClean and deep cuts characterised by paper cuts and knives are known as incisions. While these wounds do not tend to bleed a lot, there may be underlying damage to tendons and other tissues.

Lacerations are jagged wounds, which tend to bieed a lot.
Puncture wounds are, as their name suggests, deep injuries caused by a long object such as a knitting needle. They do not tend to bleed a great deal but they carry the risk of infection as dirt can be carried a long way into the tissue. There is also a greater risk of damage to vital organs such as the lungs or liver.

Grazes are a commonplace injury and involve damage to the top layers of the skin. They do not cause major blood loss but are often dirty, as grazes tend to have debris embedded within them.

How does the body stop bleeding?
When a blood vessel is torn or cut, a series of chemical reactions takes place that causes the formation of a blood clot to seal the injury. Components of the blood known as platelets clump together at the injury site. Damaged tissue and platelets release chemicals that activate proteins called clotting factors. These react with a special protein (fibrinogen) to form a mesh of filaments that traps blood cells. These form the basis of a blood clot that contains white blood cells to help fight infection and specialised blood cells that help promote repair and recovery. A scab will form to protect the wound until repair has taken place. When applying pressure to the site of a wound you are helping the clotting process.

 

[sakuraguy]

Breathing Difficulties

In a first aid situation you are likely to encounter a casualty who has breathing difficulties. Psychological stress may trigger breathing problems that affect the blood's chemical composition, causing a range of symptoms that make the casualty feel unwell. Accidents that include a heavy impact to the chest can cause injuries that result in severe breathing difficulties.

Hyperventilation

This is a breathing difficulty that may be triggered by the stress of an accident or some other form of emotional shock. The person over-breathes, causing the level of carbon dioxide in the blood to drop. This leads to a combination of the signs and symptoms listed below:

Fast, shallow breathing
Feeling of pins and needles in the limbs
Dizziness
Cramps
Panic attacks
Treatment
If the casualty is otherwise uninjured, remove her from the scene of the accident to a quiet place where there is no audience. People who are hyperventilating often subconsciously react to onlookers, making themselves worse.
Reassure the casualty but remain calm and speak firmly. Encourage the casualty to regain control of her breathing.
If the situation persists, and you are certain that there is no other underlying condition such as asthma or chest injury, let the casualty inhale her own breathed-out air from a paper bag. This air contains more carbon dioxide and this will help restore the balance of oxygen and carbon dioxide in the blood.
Call a doctor or ambulance if symptoms do not disappear. Do not slap the casualty - she may become violent and attack you, and you run the risk of being charged with assault.
Chestinjuries

Serious injuries following an accident, or the aftermath of any illnesses causing problems with breathing, can lead to the lung collapsing. Air enters the space between the lung and the chest wall, making breathing very difficult. In severe cases, the pressure affects the uninjured lung and the heart, causing a tension pneumothorax, a condition requiring urgent medical attention if the casualty is to survive.

Chest injuries with more than one broken rib will often result in the casualty having difficulty in breathing as the chest wall is unable to move effectively. There may also be an open break on the chest wall where ribs have sprung out. Remember that the ribs extend around the back and there may be injuries here as well as on the front.

Chest injuries may be accompanied by a sucking wound to the chest. Here there is a direct passage between the outside and the lungs, often caused by a puncture injury from a sharp object pushing through the chest wall.

Signs and symptoms of collapsed lung and other chest injuries
History of chest impact or recent illness affecting breathing
Chest rises as the person breathes out(paradoxical breathing)
Swelling or indentation along the line of the ribs
Open fractures
Difficulty in breathing
Pain on breathing
Shock, as there is likely to be some degree of internal bleeding
Bright red, frothy blood coming from the mouth and/or nose. (This is an indication of a punctured lung as oxygenated blood is escaping from the respiratory system. There may or may not be an associated sucking wound to the chest.)
Sucking wound to the chest
Treatment
Ensure that an early call for emergency medical help has been made. If the casualty is conscious, she will often find it easier to breathe if sitting up. Help the casualty into a sitting-up position if possible and provide support to remain in this position comfortably. If you can determine the side of the injury, lean the casualty to the injured side. This helps relieve pressure on the good lung, allowing the casualty to breathe a little easier.

If there is an open sucking wound to the chest, cover this up as soon as possible. The best cover comes from using plastic sealed on three sides over the wound area. Help the casualty remove blood from her mouth. If the person becomes unconscious, place into the recovery position on the injured side and monitor breathing carefully. Treat any open wound once the person is in the recovery position. Treat any broken ribs.

 

[sakuraguy]

Burns and Scalds

Burns and scalds, a type of burn caused by wet heat, are potentially fatal injuries. They can cause life-threatening shock through serious fluid loss and, if around the face and neck, can restrict breathing.

What are the risks from burns?

In burns, fluid is lost in three main ways:

Blistering
Swelling around the injury
Directly from the injury
While the fluid loss may not be visible as liquid lying around the casualty it is nevertheless lost from the blood as a straw-coloured substance known as plasma. Severe burns therefore can and often do prove to be fatal.

The second risk from burns is infection. The damaged tissue provides little or no resistance to infection and serious problems may arise some time after the initial injury. The risk of infection increases with the size and depth of the burn, and the casualty will probably suffer from shock as well.

Causes of burns
Dry heat This is the most common type of burn and includes burns caused by hot objects such as exhausts or by cigarettes or lighters.

Wet heat Also known as a scald, wet heat usually refers to hot water or steam but it can also include other hot liquids such as oil or fat.

Friction When two objects rub together very quickly friction generates heat, causing another kind of dry burn.

Chemical burns Industrial and household chemicals can cause serious burns.

Electrical burns These can be caused by the everyday low-voltage currents found in switches, wires and appliances around the home or from the high-voltage cables scattered around the countryside in the form of power lines, railway tracks and so forth. In rarer cases electrical burns can be caused by lightning strikes.

Radiation burns While this may sound dramatic, most of us have suffered some degree of radiation burn at some point in our lives - more commonly referred to as sunburn.

Depth of the burn

Burns are classified into three types:

Superficial burns only involve the outer layer of skin and, although often extremely painful, are generally not life­threatening unless a very large surface area of the body is covered. The burnt area is very sore and is usually red and possibly a little swollen. If good first aid treatment is applied and the area burnt is not extensive, then further medical treatment is unlikely to be needed.

Partial thickness burns include the top layers of skin and involve blistering. They are characterised by red, raw­looking skin with blisters that weep clear fluid, and pain. The risk of shock is high with partial thickness burns and any burn of this type needs medical attention. Partial thickness burns covering a substantial percentage of the body can kill.

Full thickness burns involve damage to all the layers of skin, usually including the nerve endings and other underlying tissues and organs. Characterised by charred tissue often surrounded by white waxy areas of dead skin with damaged nerves, full thickness burns will always need emergency medical attention and in the long term will often require plastic surgery.

Area of the body burn

Generally, the larger the area of the body burned, the more serious the burn. Any burn to the face or neck needs urgent medical attention. As a general principle, if the casualty has other injuries, appears to be in a great deal of pain, is showing signs and symptoms of shock, is having difficulty breathing, or you have other reasons to suspect that his or her condition is more serious, then call an ambulance whatever the extent or depth of the burn.

How do you tell how severe a burn is?
Many burns are minor and can be safely treated at home or with help from a local doctor or pharmacist.

However the size and depth of the burn will tell you if it needs urgent medical treatment.




How to Treat Burns and Scalds
The general treatment of all burns is very simple: cool and cover the affected part, and seek appropriate medical help. Before you do anything else, make sure that you protect yourself This is particularly important at burns incidents. Ensure that the fire is out, that any electrical equipment is safely disconnected or that any chemical spills are not going to affect you.

First Aid Treatment
Monitor the casualty's airway and breathing. This is particularly important if the casualty has burns to the mouth and airway. Be prepared to resuscitate if necessary.
If possible lay the casualty on the ground to help reduce the effects of shock.
Douse the burnt area with cool liquid. Cooling the burn will reduce the pain, swelling and risk of scarring. Restrict the cool liquid to the injured part where possible because over­cooling could lead to hypothermia, particularly if the surrounding air temperature is low. If applying water from a shower, hose or even a gushing tap, ensure that the pressure is minimal because water hitting burnt skin at speed will add to the pain and the damage.
Make an assessment about whether or not an ambulance is needed and call for help.
Keep cooling the injured part until the pain stops. Often 10 minutes is sufficient but if the casualty still complains of pain after this time then continue with the cooling treatment.
Remove rings, watches and other potential constricting items as burns swell up. Take care to return these items to the casualty.
Once the pain has eased, cover the wound to prevent infection. This should be done with a sterile bandage if possible, tied very loosely over the burn. If in any doubt as to whether material may stick to the wound, do not attempt to cover but continue to cool the burns continuously until medical help arrives. If you are having to improvise, any clean, non­fluffy material can be used - ideal examples are clean handkerchiefs, cotton pillowcases or clingfilm.
If possible, raise the injured part as this can help to reduce swelling.
Wait with the injured person until help arrives or, if the burn is less serious, accompany her to further medical attention.

Treat for shock.
Maintain a check on the casualty's airway, breathing and circulation.
Keep checking bandages to ensure that they are not too tight.
Warning
Do not over-cool the casualty.
Do not apply water under pressure.
Do not remove burnt clothing if it is sticking to the wound.
Do not put cotton wool or any other fluffy material on to a burn as it will stick to the injury.
Do not put any creams or ointments on to a burn as these will need to be removed at the hospital.
Do not burst blisters as this may increase the risk of infection.
Summary
Check for danger
Assess ABC (be prepared to resuscitate if necessary)
Cool the injured part
Make an appropriate decision aboUt what help is required and call for an ambulance if necessary
Cover the injured part
Treat for shock throughout your treatment of the burn
Elevate the injured part if possible

 

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Chemical Burns and Eye Burns

While the general rules for the treatment of burns are the same, regardless of the type of burn, there are some additional considerations for chemical burns. The key point when dealing with chemicals is not to contaminate yourself. Chemical spills are not always obvious - some very toxic chemicals look like water - so look for signs such as a hazchem (hazardous chemical) label, empty chemical containers or guidance from bystanders. If in doubt, call the emergency services rather than approach the injured person yourself. Remember that some household substances can cause chemical burns, particularly cleaning materials such as oven cleaner.

Treating chemical burns

If you feel that you can safely approach the casualty, then do so carefully.
If necessary, wear protective clothing to protect yourself from contamination.
Ventilate the room if possible because many chemicals affect breathing.
When cooling the burn with water, ensure that the contaminated water runs away from both the casualty and yourself. It may be necessary to flood the injured part for longer to ensure that the chemical is totally washed away. This may take more than 20 minutes.
Call an ambulance. Make sure you have mentioned that it is a chemical burn so that additional help can be sent from the fire service if necessary and so that any antidotes can be sent with the ambulance.
If possible, remove contaminated clothes from the casualty as these may keep burning, but only do this if you can do it without contaminating yourself or harming the casualty more.
Cover the burn with a clean, non-fluffy material as appropriate and tie loosely in place if necessary.
Treat for shock and reassure the casualty until emergency help arrives on the scene.
What if the chemical reacts with water?

Some industrial chemicals do react badly with water. Where such chemicals are used, people working with them should have been trained in the use of an antidote. If there is nobody around with this expertise, do not waste time looking for an antidote - apply liberal amounts of water to try to wash the chemical away.

Chemical burns to the eye

Chemical burns to the eye can be very serious. Early rinsing of the eye with cold water will help to flush away the chemical and reduce scarring.

Signs and symptoms of chemical burns to the eye
Known exposure to chemical
Intense pain
Redness and swelling
Reluctance or inability to open the eye
Tears from eye
Treatment
Protect yourself, the casualty and bystanders from further contamination.
Hold the affected eye under cold running water for at least 10 minutes to flush out the chemical, allowing the injured person to blink periodically. You may need to hold the eyelid open. Make sure that the water flow is gentle. Do not allow contaminated water to fall across the good eye and so contaminate that eye also.
Ask the injured person to hold a non-fluffy sterile or clean pad across the eye, tying it in place if hospital treatment may be delayed.
Take or send the person to hospital with details of the chemical if possible.
Flash burns to the eye

Caused by looking into very bright light, flash burns damage the surface of the cornea, the transparent front of the eyeball. Recovery can take some time and in some instances the damage can be permanent (for example, if a person has looked at the sun through a telescope without appropriate protection).

Signs and symptoms of flash burns to the eye
Known exposure to intense light (which may have happened some time ago)
Intense pain
Feeling that there may be something in the eyes
Redness and watering
Both eyes affected
Treatment
Check the history to rule out chemical burns or a foreign body in the eye.
Reassure the injured person, and wear gloves to prevent infecting the eye.
Place pads over both eyes and bandage in place if it will be some time until medical help arrives. Remember that this will effectively blind the person temporarily so stay with her to reassure and guide.
Take or send the person to hospital as she will need medical attention.
Contact lenses

Where there has been any injury to the eye, encourage the injured person to leave contact lenses in place.

 

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Treating Chest or Abdominal Wounds

The chest wall protects the lungs, heart and other essential organs such as the liver. A puncture wound to the chest can therefore be extremely serious. Wounds to the abdomen (stomach and intestines) are very serious. External bleeding may be severe and internal bleeding is likely, both of which will lead to serious shock. In addition, there may be damage to internal organs and the digestive system.

Chest wounds

Common complications of penetrating chest wounds include:

Collapsed lung (pneumothorax), caused by air entering the space between the chest wall and the lungs. This applies pressure to the lungs, causing them to collapse. The lung can also be damaged directly, causing it to fill with blood.
Tension pneumothorax which occurs when the pressure builds up sufficiently to affect the uninjured lung and possibly even the heart.
Damage to vital organs such as the liver - this will result in severe shock as these organs have a large blood supply.
Signs and symptoms of chest wounds
Difficulty with breathing
Shock
Bright red, frothy blood (blood with air in it) being coughed up or escaping from the wound
Pale skin with blue lips
sound or air being sucked into the chest
First Aid Treatment
Seal the wound using, in the first instance, your hand or the casualty's hand.
Help the casualty into a position that makes it easier for him to breathe. This will usually be sitting up and inclined to the injured side. This allows the uninjured lung maximum room to move and allows blood to pool on the injured side.
Cover the wound with a dressing and cover the dressing with airtight material, such as plastic or foil. Seal this on three sides.
Call an ambulance and treat for shock.
If the casualty is unconscious, monitor and maintain the airway and be prepared to resuscitate if necessary (sealing the wound before resuscitating). Place the casualty injured side down.

Treating abdominal wounds
Call an ambulance and help the casualty to lie down in the most comfortable position.
Consider the position of the wound. If it is vertical - runs down the abdomen - moving the casualty so that he is lying flat on the ground will help bring the edges together, ease discomfort and help reduce bleeding. If the wound is horizontal, gently raising the legs will have the same effect.
Place a large dressing over the wound and secure in place. Add pads to this dressing as necessary.
Treat for shock.
Support the wound if the casualty coughs, vomits or needs to be moved into the recovery position. Press lightly on the bandage to prevent intestines protruding from the wound. If intestines are protruding, do not attempt to replace them. Cover with a clean piece of plastic film.
Major organs

Damage to any of the body's major organs can be life-threatening and prompt action must therefore be taken to minimise the effects of injuries to the chest or abdomen. Even when external bleeding is slight, the risk of internal bleeding cannot be discounted. Knowing whereabouts in the body the organs are located will help a first aider to assess a situation and decide the most appropriate emergency treatment, and also to give accurate information when the emergency services arrive.

 

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Concussion
In itself, concussion is not a serious injury as the casualty will recover when the disturbance caused by the impact stops. However, because concussion often accompanies violent head movement, there is always the possibility of a skull fracture or more serious, longer-term brain injury, such as compression. It is important therefore that even a seemingly recovered casualty with concussion should seek medical treatment.
How to treat concussion

Place the casualty in the recovery position if necessary and monitor ABC.
Call an ambulance if the casualty does not recover after 3 minutes or if there are signs of skull fracture or compression.
Advise the casualty to seek medical advice if recovery appears to be complete.
Encourage the casualty to keep still while recovering as this reduces dizziness and nausea.
Be aware of the increased likelihood of neck injuries.
Compression

Compression is a very serious injury that occurs when pressure is exerted on the brain, either by a piece of bone, bleeding or swelling of the injured brain. It may develop immediately after a head injury or stroke, or some hours or even days later.

Signs and symptoms of compression
Person becomes increasingly drowsy and unresponsive.
Flushed and dry skin.
Slurred speech and confusion.
Partial or total loss of movement, often down one side of the body.
One pupil bigger than the other.
Noisy breathing which becomes slow.
Slow, strong pulse.
How to treatcompression

If some or all of these symptoms are present, suspect compression and carry out the following treatment.

If the casualty is unconscious, place in the recovery position and monitor airway, breathing and circulation.
If conscious, lay the casualty down with the head and shoulders slightly raised, maintaining a close check on the ABC. Call an ambulance, and be prepared to resuscitate.
Warning
Do not give anything to eat or drink - the casualty may need a general anaesthetic in hospital.

 

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Controlling Bleeding from the Mouth and Nose

There a number of potential reasons for bleeding from the mouth. If the bleed is a result of direct impact to the face, there are likely to be injuries to the jaw and possibly the cheekbone, as well as to the gums and teeth. It may also be that the bleed follows dental treatment. In the case of nosebleeds, find out what caused the nosebleed so you can establish whether the nose or checkbone has been damaged. Many nosebleeds start spontaneously and the cause is never known. The priority with any mouth or nosebleed is to protect the casualty's airway and try to prevent blood being swallowed as this may cause vomiting.
How to treat bleeding from the mouth
Lean the casualty forward and encourage her to spit out any blood and/or broken teeth into a receptacle.
If the bleed is easy to reach, controlling it may be helped by placing a small dressing over the wound and encouraging the casualty to apply pressure for 10 minutes.
If there is a severe bleed from a tooth socket, place a rolled-up dressing, large enough to stop the teeth from meeting, into the mouth and ask the casualty to bite on it. If this does not control the bleeding after 10 minutes, reapply a clean pad.
If the bleeding has not stopped after 30 minutes, or is particularly severe, either take or send the casualty to hospital. There may be damage to the jaw or cheekbone. Cold compresses may relieve this pain and reduce swelling and you may need to support broken bones with pads or your hands.

If the nose or cheek appears to be broken

Lean the casualty forward and encourage him to spit out blood. Do not pinch the nose. Cold compresses either side of the injury may provide some relief and help to reduce the bleeding.

If a tooth has been knocked out

Adult teeth can sometimes be replanted in the mouth, so it is worth storing the tooth carefully. Do not wash the tooth; instead, place it in a labelled plastic bag with some milk or water to keep it moist, and send with the person to the emergency dentist or hospital. Teeth need to be replanted quickly - go to a dentist or hospital emergency department.